I was well warned of the future of anesthesiology, and I did it anyway. I have a close friend from high school who now works as physician recruiter, who painted a dismal projection of a saturated job market with a flood of heavily indebted applicants applying for salaries in the low 200's. Maybe they're right. Maybe the coming years will prove me to be foolish, but I had a previous career where I competed in a really tight job market, and I survived. It was tough, but I pulled it off.
At the end of the day, I found it to a field of study that I actively wanted learn about, and a skill set that I wanted. I was also interested in some IM subspecialties, like ID, cards EP, and also in Emergency Med. I wasn't sure I had the stamina to push hard all the way to get the EP fellowship (nor am I immortal), and primary care/hospitalist IM was not what I wanted to do with my life.
I found EM to be a continually futile push against an inexorable flood of human misery, and I wearied of the sort of interactions the bread and butter stuff forces you to have with patients. Mostly what got to me was the sad ordinary situations, like having to work up a poorly informed guy with a chronic non emergent problem, and having to order enough expensive tests to ruin his next few months financially, just to satisfy the algorithm. I found myself really looking forward to the end of the shift. Not a good way to start a career. Surgery was fun, but kind of a grind once the initial thrill wore off. OB kind of sucked. Peds, good to know, not that interesting to me. Psych came pretty naturally to me, but frankly, I tend to be a physically active person, which ultimately killed rads for me too. Things not working out with Rads was kind of a tragedy, since we were a good match, according to those personality tests. Family Med? Actually a really nice rotation in med school, but long term... Meh. Ophthalmology: Definitely cool, like the physics, the gadgets. Really a field for people with better fine motor skills than me. You have to accept your limitations sometimes. Forensic Path: Super interesting, honestly pretty fun in a macabre way, but... the STENCH of a bloater... Damn. No.
So why anesthesiology? Really it all started in second year pharm class, learning about the drugs. Definitely interesting, if you have any kind of imagination. I found myself really curious on surgery and OB, wanting to ask questions of the anesthetist or anesthesiologist. I did a rotation, and I liked the workflow, and the thought process that went into planning and performing cases. I liked the physics and chemistry of the machine, the physiology of the heart, lungs and brain. I still do, and I want to learn more about it.
I can appreciate the perspectives voiced in this forum, and recognize that they come from experience. On the other hand, anesthesiology seems like a fair opportunity to work hard and make a decent living, probably not nearly the way it once was, but I think that is true of medicine as a field in general. At the very least, the 3 years of anesthesia training and then critical care seem like a pretty good way to live out the next stretch of my life.
